*Candidates must have a background in Oncology*

• Receive requests for prior authorizations and ensure that they are properly and closely monitored within company-set standards.
• Verify insurance eligibility and benefits via portal, phone, email or fax
• Submit prior-authorization request and make timely follow up calls
• Reviews and tracks prior authorization data. Reaches out to insurance carries in order to obtain extensions of current prior authorizations on file.
• Coordinate with intake staff in obtaining necessary documentation to support medical necessity and authorization approval.
• Review the accuracy and completeness of the information requested and ensure that all supporting documents are present.
• Assist with medical necessity documentation to expedite approvals and ensure that appropriate follow-up is performed.
• Collaborate with other departments to assist in obtaining prior authorizations/appeals.
• Document all interactions with insurance companies within the company system.
• Document all prior authorization information, including approval dates, billing units, procedure codes, and prior authorization number in the patient profile.
• Proactively work on prior authorizations that are due to be expired.
• Secure patients’ demographics and medical information by using discretion and ensuring that all procedures are in sync with HIPAA compliance and regulation.
• Conducts job responsibilities in accordance with the standards set out in the Company’s Code of Business Conduct and Ethics, its policies and procedures, the Corporate Compliance Agreement, applicable federal and state laws, and applicable professional standards.
• Completes all required duties, projects, and reports in a timely fashion on a daily, weekly, or monthly basis per the direction of the leadership.
• Other duties as assigned.